OrganizationActive
Extendicare Homes, Inc.
NPI 1407927148 · Skilled Nursing Facility · Port Washington, WI
Provider details
- NPI number
- 1407927148
- Entity type
- Organization
- Primary specialty
- Skilled Nursing FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Donna Maassen, Director of Compliance(414) 908-8119
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1119 N Wisconsin St
Port Washington, WI 53074-1209
Phone: (262) 284-5892
Fax: (262) 284-1612
Street-level locationGet directions
Mailing address
111 W Michigan St
Milwaukee, WI 53203-2903
Other names (DBA / former)
- Doing business as
- Heritage Nursing and Rehabilitation Center
Registry dates
- Enumerated
- 2006-11-13
- Last updated
- 2008-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.